7 days in healthcare (April 29th-May 5th, 2024)
Summary
From the point of view of Biomedicine, apart from advances in biological sciences, the American Journal of Medicine reflects in open articles on two very new elements in the new medical practice: what face-to-face contacts with the patient represent versus digital ones and the importance of Artificial Intelligence in the doctor-patient relationship. Digital technologies can revolutionize the way healthcare is delivered, enabling convenient, remote consultations. This should not lead us to underestimate the value of personal contact, which creates relationships and trust between patients and healthcare professionals. Non-verbal communication and physical examination are two great advantages of the in-person relationship. However, there are also numerous studies that show that telemedicine and telephone consultations have advantages in certain circumstances. Regarding AI in medicine, the conclusion is that, although evolving, it can offer great advantages, which are not available today. Animal experimentation raises hopes for the emergence of a universal flu vaccine, avoiding dependence on annual doses adapted to each year’s versions of the virus.
Regarding Global Health, New England Journal of Medicine editorial: The search for transformative tools to eradicate malaria. The conclusion is that there is no “silver bullet”, but rather a combination of interventions through a set of products and actions. Science Editorial: A treatise on pandemics is within reach. At the end of May, 194 WHO member countries will meet in the Assembly that will discuss the pandemic treaty, discussed over two years. In the course of the discussion, a false dilemma has emerged between science and innovation and equity. Equity is an ethical imperative. The Lancet Editorial: Housing as an important determinant of health. Unhealthy housing is correlated with poor health outcomes. Various articles point out the impact of climate change on very serious threats to health: the emergence of resistant superbacteria, the explosion of zoonotic diseases and the resurgence of malaria.
In terms of International Health Policy, the American government is about to classify cannabis as a less dangerous drug. Already three-quarters of Americans live in states where this drug is legal. This new federal classification could have significant economic repercussions. Important legislative changes regarding abortion in Arizona and Florida. President Biden proposes to regain, through a law, federal control over this issue. This law has no chance of being approved. Both immigration and abortion are the two big issues of this year’s American presidential campaign. In Sweden, the social model, to the limit. Conflicts are repeated among workers of the welfare state. The European Union publishes an evaluation of the implementation of the 2011 cross-border health directive (Directive 2011/24/EU). As is known, this Directive allows you to claim non-urgent health care in a European country other than the one of residence with an expense reimbursement system. The study, which analyzes 2022, draws attention to the low number of requests for assistance in Spain, despite being a tourist power that receives tens of millions of European tourists each year.
If we talk about National Health Policy (Spain), the government approves the Anti-Tobacco Plan 2024-2027, without raising the price of tobacco, which is criticized by experts, despite the fact that the increase in tobacco taxation was in the document approved on April 5 in the Interterritorial Council. The Non-Smoking Association says that, without an increase in the price of tobacco, we will continue to be Europe’s tobacconist. According to the WHO, tobacco taxes are the most effective means of reducing the prevalence of smoking. In most European countries, tobacco taxes are between 80 and 90 percent, while in Spain it is 51 percent. 22.1% of the adult population in our country continues to smoke, according to the 2020 European Health Survey and it causes close to 50,000 deaths per year. The fact that the price of tobacco has not been modified and that certain measures of the Plan require the approval of laws, in a highly uncertain legislature, mean that the Plan runs the risk of becoming a dead letter, despite the publicity from which it has come. accompanied by its approval. The Zendal hospital in Madrid already cares for ALS patients. The Community received advice from experts, relatives and caregivers of ALS, regarding the non-participation of these groups in the opening of the hospital itself, which is why the change in criteria of action must be celebrated. In Asturias, 400 positions that are difficult to fill are detected, only among doctors, according to the medical union. According to this union, the solution is to offer economic and non-economic incentives. Among the latter are aid to families, daycare, travel and housing. All of this is in contradiction with the current Statute-Framework, which is so allergic to any form of individual and collective recognition and differentiation. Given the instability among healthcare personnel in Catalonia, the president of the Council of Medical Associations demands an escape from the civil service system and asks to provide the teams with freedom and management capacity. Galicia has success with the vaccine against respiratory syncytial virus against childhood bronchiolitis. This winter, the community has immunized nine out of ten babies against RSV and has managed to prevent 80% from ending up in the hospital. Interesting initiative in some autonomous communities, such as Madrid and Murcia, by offering financial aid, if certain requirements are met, for access to the dentist, beyond the limited coverage of the public system.
As for Companies, internationally, Pfizer plans a direct-to-consumer platform for covid and migraine medications. The American group follows Lilly in setting up a website for patients to obtain medication online. NovoNordisk cuts price of anti-obesity drug Wegowy as competition heats up. As for national information, in Spain anti-obesity therapy from NovoNordisk (Wegovy, which will be available in pharmacies in the coming days) will cost up to 292 euros per month. Hipra announces its Covid vaccine adapted to the JN1 variant for this fall. The Quirón hospital in Gijón faces the latest urban planning procedures.
Biomedicine
- Commentary from the American Journal of Medicine: Direct face-to-face encounters versus digital ones in the clinic. Face-to-face contact has been used in medicine for millennia. Digital technologies can revolutionize the way healthcare is delivered, enabling convenient, remote consultations. This should not lead us to underestimate the value of personal contact, which creates relationships and trust between patients and healthcare professionals. Non-verbal communication and physical examination are two great advantages of the in-person relationship. However, there are also numerous studies showing that telemedicine and telephone consultations have advantages in certain circumstances (https://www.amjmed.com/article/S0002-9343(23)00428-X/fulltext#:~:text=The%20physical%20presence%20of%20a,understanding%20between%20the%20parties%20involved.)
- Artificial intelligence and doctor-patient relationships. The conclusion is that AI in medicine, although evolving, can offer great advantages, which are not available today. The New England Journal Medicine has decided to launch a new journal entirely dedicated to AI (https://www.amjmed.com/article/S0002-9343(24)00043-3/fulltext)
- A universal flu vaccine shows 100% efficacy in animals. This would avoid dependence on an annual dose adapted to the versions of the virus each year (https://www.abc.es/salud/enfermedades/vacuna-universal-gripe-muestra-eficacia-100-animales-20240503121220-nt.html#). Access to the original article: https://www.science.org/doi/10.1126/scitranslmed.adj4685
- An experimental vaccine increases survival by up to 50% in four people with lethal brain cancer (https://elpais.com/ciencia/2024-05-01/una-vacuna-experimental-aumenta-hasta-un-50-survival-in-four-people-with-lethal-brain-cancer.html). Access to the original document: https://www.cell.com/cell/abstract/S0092-8674(24)00398-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867424003982%3Fshowall %3Dtrue
- They discover a possible cause of the increase in the incidence of cancer at an early age (https://www.larazon.es/salud/descubren-posible-causa-aumento-incidencia-cancer-edades-tempranas_20240430663102bec0b95c0001d4f84d.html#:~:text=A%20new%20study%20suggests%20that,permanent%20mutations%20in%20%20DNA&text=In%20the last%20%20decades%2)
- Synchronization between circadian clocks can prevent aging (https://elpais.com/salud-y-bienestar/2024-05-03/la-sincronizacion-entre-los-relojes-circadianos-del-organismo-may-prevent-aging.html). Access to the original article: https://www.cell.com/cell-stem-cell/abstract/S1934-5909(24)00140-1
- Could ketamine be the fix for depression at work? This drug is increasingly offered at meetings organized by companies, in their health schemes (https://www.ft.com/content/24dc4c2d-4326-46ac-b1d5-8b448eb7be4d)
Global Health
- New England Journal of Medicine Editorial: The Search for Transformative Tools to Eradicate Malaria. The conclusion is that there is no “silver bullet”, but a combination of interventions through a set of products and actions (https://www.nejm.org/doi/full/10.1056/NEJMe2402430)
- Science Editorial: A treatise on pandemics is within reach. At the end of May, 194 WHO member countries will meet in the Assembly that will discuss the pandemic treaty, discussed for two years. In the course of the discussion, a false dilemma has emerged between science and innovation and equity. Equity is an ethical imperative (https://www.science.org/doi/10.1126/science.adq1055)
- The Lancet editorial: housing as an important determinant of health. Unhealthy housing is correlated with poor health outcomes. The Adequate Housing Index exposes huge disparities with a third of homes in emerging economies failing to meet adequate standards. Objective 11.1 of the Sustainable Development Goals aims to ensure adequate housing by 2030 (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00914-0/fulltext)
- Women live longer with illness than men (https://www.theguardian.com/society/2024/may/01/women-live-more-years-ill-health-than-men-gender-health-gap-study)
- Deforestation opens avenues for the spread of diseases from animals to humans (https://www.ft.com/content/31ade5f9-8e32-4efc-8bf0-6af7d4d9b669)
- Climate change has the risk of activating the emergence of resistant superbacteria (https://www.ft.com/content/a104c979-a3bf-4f81-a780-f82390b60d9c)
- Climate change has the additional risk of the explosion of zoonotic diseases. Global warming forces animals and humans to seek new inhabitants, offering greater proximity, creating conditions for the expansion of zoonotic diseases (https://www.ift.com/content/599c87da-7920-4832-87de-98934cb5cbc4)
- Climate change threatens the resurgence of malaria (https://www.ft.com/content/a9159d32-633f-4a48-938c-6c58effe9cf5)
International health policy
- USA
- US behind other countries in hepatitis C cures (https://www.nytimes.com/2024/04/28/health/hepatitis-c.html#:~:text=Of%20those%20diagnosed%20in%20the,agency’s%20division%20of%20viral%20hepatitis.)
- The American government about to classify cannabis as a less dangerous drug. Already three-quarters of Americans live in states where this drug is legal. This new federal classification could have important economic repercussions (https://www.lemonde.fr/international/article/2024/05/01/le-gouvernement-americain-sur-le-point-de-classer-le-cannabis-comme-une-drug-moins-dangereuse_6230846_3210.html)
- Arizona congressmen reject 1864 abortion ban law (https://www.nytimes.com/2024/05/01/us/arizona-senate-house-abortion-ruling.html)
- DeSantis’ heartbeat law, which prohibits abortion at six weeks, goes into effect in Florida (https://elpais.com/sociedad/2024-05-01/la-ley-del-latido-de-desantis-which-prohibits-abortion-at-six-weeks-comes-into-force-in-florida.html#:~:text=Abort%20after%20of%20the%20sixth,first%2015%20weeks%20%20gestation.)
- The USA suffers one of the worst outbreaks of avian flu in cows (https://www.elmundo.es/ciencia-y-salud/salud/2024/05/02/6631d6b921efa0df178b4580.html#)
- China
- The Chinese scientists who sequenced covid are excluded from his laboratory (https://www.economist.com/china/2024/05/02/the-chinese-scientist-who-sequenced-covid-is-barred-from-his-lab#)
- United Kingdom and the National Health Service
- A request is made to stop the tobacco industry from sponsoring continuing medical education (https://www.bmj.com/content/385/bmj.q950)
- France
- Social security and liberal doctors resume tariff negotiations (https://www.lemonde.fr/societe/article/2024/05/03/l-assurance-maladie-et-les-medecins-liberaux-reprennent-leurs-negotiations-tarifaires-apres-plusieurs-semaines-de-suspension_6231372_3224.html#:~:text=de%20la%20santé-,L’Assurance%20maladie%20et%20les%20mé)
- Sweden
- The social model, to the limit. Conflicts are repeated among workers of the welfare state (https://www.lemonde.fr/economie/article/2024/05/04/en-suede-le-modele-social-a-bout-de-souffle_6231436_3234.html#:~:text=Dans%20les%20écoles%2C%20les%20hôpitaux,régions%2C%20dont%20les%20deficits%20explosent.)
- Philippines
- The Philippines bans some genetically modified drugs. Although Greenpeace welcomes it, those who defend these foods say that the decision could be disastrous for poor Filipinos (https://www.economist.com/asia/2024/05/02/the-philippines-bans-some-genetically-modified-foods#)
- Russia
- Misuse of psychiatry in Russia. According to The Lancet, psychiatric facilities are being used as means of political repression (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00911-5/abstract#:~:text=A%20steep%20rise%20in%20indefinite,Kremlin%20intensifies%20crackdowns%20on%20dissent.)
- European Union
- Assessment of the implementation of the 2011 cross-border health directive (Directive 2011/24/EU). What is striking in the 2022 study is the low number of requests for care in Spain, despite being a tourist power (https://health.ec.europa.eu/document/download/69e33702-c7cc-4f0e-afc0-f3cf13e127ab_en?filename=crossborder_2022_patient-healthcare_data_en.pdf)
- Experts analyze for Diario Médico what the new European regulations bring: Artificial Intelligence and the European Health Data Space (https://www.diariomedico.com/medicina/politica/traen-nuevo-reglamentos-europeos.html)
National health policy
- Central government initiatives
- The government approves the Anti-Tobacco Plan 2024-2027, without raising the price of tobacco, which is criticized by experts, despite the fact that the increase in tobacco taxation was in the document approved on April 5 in the Interterritorial Council . The Non-Smoking Association says that, without an increase in the price of tobacco, we will continue to be Europe’s tobacconist. According to the WHO, tobacco taxes are the most effective means of reducing the prevalence of smoking. In most European countries, tobacco taxes are between 80 and 90 percent, while in Spain it is 51 percent. Although taxes on tobacco raise around 9 billion euros annually, it is estimated that the expenditure derived from smoking triples this amount. 22.1% of the adult population in our country continues to smoke, according to the 2020 European Health Survey and it causes close to 50,000 deaths per year. The materialization of the Plan’s measures will be through legislative reforms (https://www.alimente.elconfidencial.com/bienestar/2024-05-03/gobierno-tabaco-fumadores-precio-cigarrillos_3877594/)
- The Interterritorial creates the Primary Care Commission and the Waiting List Working Group (https://gacetamedica.com/politica/el-interterritorial-crea-la-comision-de-atencion-primaria-y-el-grupo-of-work-of-waiting-lists/)
- Initiatives and news from the autonomous communities
- The Zendal hospital in Madrid already cares for ALS patients, which includes medical and psychological support, rehabilitative treatment, nursing care, physiotherapy, speech therapy and occupational therapy. In the Community of Madrid there are 600 people who suffer from this disease and there are 4,500 in all of Spain. The center will be able to treat up to 60 patients daily. The Community received advice from ALS experts, family members and caregivers (https://www.larazon.es/madrid/hospital-zendal-madrid-atiende-pacientes-ela_20240429662efff28e66020001bd9204.html)
- In Asturias, 400 positions that are difficult to fill are detected, only among doctors, according to the medical union. According to this union, the solution is to offer economic and non-economic incentives. Among the latter are aid to families, daycare, travel and housing (https://www.lne.es/asturias/2024/05/03/400-plazas-medico-dificiles-sobre-101858643.html)
- The Manises hospital passes into public management after 15 years of private management. The change will occur from May 7 and until now had been managed by Sanitas. The only concession hospital in the Valencian community will be that of Elche-Vinalopó, whose contract expires on June 1, 2025, although the Ministry has already shown its willingness to extend the concession (https://elpais.com/espana/comunidad-valenciana/2024-05-04/el-hospital-de-manises-passes-to-direct-management-after-15-years-of-private-concession.html#)
- Instability among staff is becoming chronic in the Catalan health system, despite the injection of 780 million euros in salary improvements. The president of the Council of Medical Associations demands an escape from the civil service system and asks to provide the teams with freedom and management capacity (https://elpais.com/espana/catalunya/2024-05-05/la-instabilidad-se-chronic-in-the-health-system-of-cataluna.html)
- Galicia has success with the vaccine against respiratory syncytial virus against childhood bronchiolitis. The community has immunized nine out of ten babies this winter to stop RSV and has managed to prevent 80% from ending up in the hospital (https://www.elmundo.es/ciencia-y-salud/salud/2024/05/02/66335565e9cf4ac7028b4597.html). The Lancet Infectious Disease has highlighted this success: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2824%2900215-9/abstract
- Some autonomous communities, such as Madrid and Murcia, offer financial aid for access to the dentist, beyond the limited coverage of the public system, if certain requirements are met (https://www.eleconomista.es/salud-bienestar/ultimas-noticias/noticias/12797529/05/24/how-to-request-the-help-for-the-dentist-up-to-3000-euros-these-are-the-requirements.html#:~:text=For% 20access%20%20this%20service,of%20the%20Community%20of%20Madrid.)
- Life expectancy
- Spain is the country in the European Union with the highest life expectancy: 84 years, while the community average is 81.5 years, according to Eurostat (https://www.elmundo.es/ciencia-y-salud/salud/2024/05/03/66352200fc6c834a028b4580.html)
- Liver health
- The Liver Study Association publishes the National Liver Health Plan (https://aeeh.es/plan-nacional-de-salud-hepatica-reto-2032/). Access to the original document: https://aeeh.es/wp-content/uploads/2024/02/AEEH-Plan-Nacional-Salud-Hepaitica.pdf
- Quota of public dentists in Spain
- One public dentist for every 50,000 patients. Of the 40,000 registered dentists, only 3% are working in the National Health System, not even reaching 2,500 public dentists (https://www.consalud.es/dentalia/profesionales-dental/el-cupo-odontologo-publico-itis-almost-50-thousand-patients-consultations-are-not-2-minutes_143252_102.html#)
Companies
- International News
- Pfizer plans a direct-to-consumer platform for covid and migraine medications. The American group follows Lilly in setting up a website for patients to obtain medication online (https://www.ft.com/content/4e7a2bc7-0de7-4948-bfd3-bda210e56c12)
- NovoNordisk cuts price of anti-obesity drug Wegowy as competition heats up (https://www.ft.com/content/dcc1e573-0b5d-4d3a-a581-abd93388ff76)
- GSK also sues Pfizer and BioNTech for infringing patents related to the covid vaccine (https://www.elespanol.com/invertia/observatorios/sanidad/20240426/gsk-demanda-pfizer-biontech-infringir-patentes-relacionadas-vacuna-covid/850665112_0.html#:~:text=The%20pharmaceutical%20GSK%20also%20has,vaccine%20against%20the%20Covid%2D19.)
- AstraZeneca admits that its covid vaccine can cause side effects such as thrombosis. For the first time and through a legal document, as reported by “The Telegraph”, the British-Swedish company reveals that in very short cases it can cause thrombosis (https://www.elmundo.es/ciencia-y-salud/salud/2024/05/02/66338434e9cf4ab74b8b457d.html)
- Pfizer declines 20% in sales and 44% in profits due to the drop in covid products (https://www.plantadoce.com/empresa/pfizer-retrocede-un-20-en-ventas-y-un-44-in-profits-from-the-fall-of-covid-19-products#:~:text=Pfizer%20falls%20in%20sales%20and,same%20period%20of%20previousyear%20.)
- Merck invests more than 300 million euros in a new research center in Germany (https://www.plantadoce.com/empresa/merck-invierte-mas-de-300-millones-de-euros-en-un-new-research-center-in-germany)
- Amgen increases its revenues by 22% in the first quarter (https://www.plantadoce.com/empresa/amgen-aumenta-sus-ingresos-un-22-en-el-primer-trimestre-hasta-7400-millones-dollars#:~:text=The%20American%20biotechnology%20accumulates%207,400,the%20increase%20was%20of%2017%25.)
- National
- In Spain, NovoNordisk’s anti-obesity therapy (Wegovy, which will be available in pharmacies in the coming days) will cost up to 292 euros per month (https://www.eleconomista.es/salud/noticias/12792535/04/24/the-therapy-against-obesity-de-novo-nordisk-will-cost-up-to-292-euros-.html#:~:text=The%20Spaniards%20with%20obesity%20willbeableto,from%20sector%20to%20elEconomista .is.)
- Rovi closes an agreement to produce prefilled syringes and will skyrocket its income (https://www.elespanol.com/invertia/observatorios/sanidad/20240425/rovi-cierra-atrabajo-producer-jeringas-precargadas-disparara-ingresos-fabricar-third parties/850415077_0.html)
- Sanitas, new reference investor in the first digital health fund in Spain (https://www.diariomedico.com/medicina/empresas/sanitas-nuevo-inversor-rereference-primer-fondo-salud-digital-espana.html )
- Hipra announces its vaccine against covid adapted to the JN1 variant for this fall (https://diariofarma.com/2024/05/02/hipra-anuncia-para-este-otono-su-vacuna-frente-al-covid-adapted-to-the-variant-jn1#)
- Catalana de Oeste enters the shareholding of Cuideo (https://www.plantadoce.com/empresa/catalana-occidente-entra-en-el-accionariado-de-cuideo)
- The Quirón hospital in Gijón faces the latest urban planning procedures (https://www.lne.es/gijon/2024/05/03/hospital-quiron-gijon-encara-ultimos-101854361.html)